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HealthInfo Canterbury

Risks & complications of breast reconstruction surgery

Like any surgery, breast reconstruction has risks. These are some of the serious or common ones.

Breast reconstruction surgery risks

HI Surgery

Scars

Talk to your surgeon and see How breast reconstruction surgery is done for information on where your scars will be. At first, the scars will be narrow red lines. They usually become paler over six months to a year. A few people get raised, red and thickened scars (called keloid or hypertrophic). Tell your surgeon if you've had this type of scar before.

Implant or expander

After an implant, your breast won't drop to the side when you lie down. The shape may alter as you tense your chest muscles. You may be able to see the outline of the implant or its folds and ripples. The implant could turn around, and you might need surgery to correct this. Your breast may appear fuller at the top. Your whole breast will have less sensation. You could get an infection around the implant. If you have an expander, the opening, or port, can occasionally turn so that it can't be reached. If this happens, you may need further surgery to fix this.

Tissue flaps

All kinds: You may have pain or permanent numbness in your breast and in the area the flap is taken from. A sore lump can develop in your breast (called fat necrosis), but this usually goes away. You might develop an infection or a collection of blood (haematoma), which needs to be drained. Your breasts are likely to be uneven. Abdominal weakness can cause a bulge (or hernia), which occasionally needs further surgery.

TRAM flap: The blood supply to part of the reconstructed breast can be blocked. If this happens, these areas can die and may need to be surgically removed. Often this is only partial and most of the reconstructed breast remains fine. You should also expect some permanent abdominal weakness.

DIEP flap: There's a 5 to 10% chance of the blood vessels getting blocked, which usually happens in the first few days. If this happens to you, you'll need an urgent operation, which has a 50% chance of unblocking the blood vessels. Unfortunately, if this isn't successful, the entire breast reconstruction can die. Overall, there's a 2 to 5% chance of this after any operation. If this happens, you can have another breast reconstruction later, but you can't use your abdominal tissue again. There's also a small risk of long-term abdominal weakness.

General surgical risks

Blood clots

Blood clots are a serious complication. They can cause deep vein thrombosis (DVT) or pulmonary embolism (PE). Any lengthy operation can cause blood clots, but your healthcare team make every effort to avoid them. You're usually given special stockings to wear during your stay in hospital. You may also be given special medication to minimise the risk, such as a daily injection into your tummy.

Infections

These could include chest, urine and wound infections that can be slow to heal. In some surgery there's also a risk of infection in the blood (septicaemia) that can make you very unwell. Antibiotics will be used to treat these infections if they develop.

Bleeding

This can be an issue during surgery or afterwards. If you bleed too much you may need to go back to theatre for more surgery and you could need a blood transfusion. You may develop a haematoma (collection of blood) that needs draining.

General anaesthesia

The risks include allergic reactions and, rarely, potentially fatal effects on the heart and circulation. The risk is different for each person. You can discuss these risks further with your anaesthetist.

On the next page: Before breast reconstruction

Written by HealthInfo clinical advisers. Endorsed by Canterbury DHB Plastic Surgery Department. Last reviewed April 2018.

Sources

Page reference: 85843

Review key: HIBRC-85838